According to the Australian Bureau of Statistics (ABS, 2010), in 2008 50 percent of Aboriginal and Torres Strait Islander people aged over 15 had a disability or long-term health condition. Aboriginal and Torres Strait Islander adults were 1.5 times more likely than non-Indigenous Australian adults to have a disability or long-term health condition, and were more than 3 times more likely to have an intellectual disability. In 2008, 7.7 percent of Aboriginal and Torres Strait Islander people in Australia (more than 25,000) had an intellectual disability. A similar number had a psychological disability.
Aboriginal and Torres Strait Islander people with disabilities often have unique needs, yet they continue to be ‘at the periphery of all aspects of the disability sector’ (Griffis, 2010). The lack of culturally-appropriate disability services and the different understandings of the concept of ‘disability’ in many Aboriginal and Torres Strait Islander communities make acknowledgement of the rights and needs of people with disabilities difficult to achieve. Griffis (2010) identifies these other considerations:
- Identifying as a person with a disability (that is, as a person who will receive disability support or services) is seen to add to the already significant experiences of discrimination that arise from having the label of ‘Aboriginal person’. There is understandable reluctance to take on additional negative labels
- There are often no comparable words for ‘disability’ in traditional languages, which suggests that the experience of ‘disability’ may have been accepted as part of the normal range of human experience
- Aboriginal people and their families can sometimes experience significant stigma due to a cultural belief that disability is the result of ‘married wrong way’ or other wrong doings on behalf of the family or parents. This is more likely in communities where a more traditional lifestyle is practised
- The predominant medical model of disability (and the Australian Government’s Close the Gap initiative) has focussed heavily on primary health interventions – in contrast to the social model of disability, which acknowledges and attempts to deal with the social construction of disability and the injustices that contribute heavily to people’s negative lived experience of disability
- Most Aboriginal and Torres Strait Islander people prefer to seek assistance from Indigenous organisations; few of these provide disability-specific services.
Cultural awareness is an extremely important aspect of counselling practice with Aboriginal and Torres Strait Islander people, and the differences in cultural and life experiences between Aboriginal and Torres Strait Islander people and non-Indigenous Australians can be a big deterrent for Indigenous Australians in seeking assistance from mainstream service providers (Fan, 2007).
The history of mistrust of white Australians since colonisation has a significant impact on Indigenous people’s ability to trust non-Indigenous counsellors in a clinical setting. Where possible, it is important to engage with Indigenous services, community members or family members who can support an individual’s engagement with a counsellor.
Relationships and kinship ties are central to the social and cultural values of many Aboriginal and Torres Strait Islander people, and it is imperative to make connections with and show respect for the family members and wider community that the person belongs to. Developing good networks within the community and with Indigenous service providers will both increase practitioners’ cultural understanding as well as their clients’ levels of trust in individual practitioners as people who care about their lives and want to understand their needs and lived experiences.
Counsellors need to be mindful that not all kinship ties will be helpful or supportive to their clients, and that a lot of people may be unwilling to discuss potentially ‘shameful’ personal issues with a worker if they think that family members will find out. These issues need to be explored and assurances need to be made to the client that family and community are welcome to be involved as much or as little as the client chooses. It might be helpful to ask a trusted person in the client’s life to support them in the initial stages of counselling – to define the meaning of confidentiality for that particular person, whom they want involved, whom they do not want involved, and teasing out the issues of confidentiality and duty of care.
‘Talk-based’ therapies can be difficult for some Aboriginal and Torres Strait Islander people, often because practical issues relating to daily living and resources take precedence over more personal, psychological issues (Fan, 2007). The disadvantaged socio-economic and physical living conditions that many Aboriginal and Torres Strait Islander people live with are likely to be intensified for people with intellectual disability.